2. The patient will have a urinary output of at least 30 mL/ hr The patient will have stable vital signs for at least 10 hours out the 12 hour shift (minimal changes; there will be no trend alert) DOB: 7/19/1966 (54y) His chest pain improved with the nitroglycerin. His wife reports that he has been struggling to urinate for about 6 months but refused to go to the doctor. embolus What are the pros/cons of government and political involvement in Dodd-Frank Act: Exhibit 7.A, p. 145. (Include Pathophysiology of Disease Process) If Carl Shapiro would have had ROSC, what would your next intervention be? Discuss safety aspects during defibrillation. When administering medication to pt w/ suspected MI, the nurse understands that morphine has which of the following beneficial effects? Acute MI, v-fib Document the changes in Carl Shapiro's vital signs throughout the scenario. View full document End of preview. All of the exams use these questions, Philippine Politics and Governance W1 _ Grade 11/12 Modules SY. & anxiety, Monitor continuos ECG Carl Shapiro vsim./; complete solutions/rated A Course NURSING NF 214 Institution Herzing University CONCEPT MAP WORKSHEET DESCRIBE DISEASE PROCESS AFFECTING PATIENT (INCLUDE PATHOPHYSIOLOGY OF DISEASE PROCESS) Coronary artery disease- Increased blood levels of low-density lipoprotein (LDL) irritate or damage the inner layer of coronary vessels. or decrease pts 3. Oxygen to maintain SpO2 >92% Myocardial infarction (MI): a heart attack happens when a part or parts of the heart dont get enough oxygen. WBC count AED determined shock was needed, continued CPR until pt spontaneauly regained his breathing. - Encourage approach, pertinent LEARN FLOW - STEP FOUR 4 Complete the Post-Quiz, you must achieve 100% Is the following statement true or false? : an American History - Chapters 1-5 summaries, 10 Cualidades DE Josue COMO Lider en la biblia en el antiguo testamento y el ejempolo que no da, Carbon Cycle Simulation and Exploration Virtual Gizmos - 3208158, Leadership class , week 3 executive summary, I am doing my essay on the Ted Talk titaled How One Photo Captured a Humanitie Crisis https, School-Plan - School Plan of San Juan Integrated School, SEC-502-RS-Dispositions Self-Assessment Survey T3 (1), Techniques DE Separation ET Analyse EN Biochimi 1. o Students are to complete the reflection questions, which are included in the 6. breathing, May positively affect Get a new set of vital signs and monitor for any trend alerts 3. Any orders or recommendations you may compare to previous - determines CV response to activity vSim ISBAR ACTIVITY pain source and also PHARM-4-FUN PATIENT EDUCATION WORKSHEET 4. Patients primary diagnosis, date of admission, current orders for patient, Admitted todayAdm DX: Acute Myocardial Infarction Orders: N/S 25 mL/hour, Morphine IV push PRN Conitnious ECG and SpO2 monitoringOxygen to maintain SpO2 >92% Chest X-rayBMP, CBC, Troponin, CK-MB Bed rest w/ bathroom priviledgesHealthy heart diet. Quality indicators that you are performing resuscitation correctly are seeing a minimal rise in the chest and if the PT begins to return of spontaneous respiration. ECG, Auscultate lungs (crackles), chest x-ray, assess 2. - Patient will develop circulatory overload from infusion of normal saline vSim ISBAR ACTIVITY the carotid pulse should be assessed every 2 min. Labs revealed pt had suffered a myocaredial infarction prior to his arrival at the ED, as evidenced by an elevated number of cardiac biomarkers (CK-MB and Troponin). 2. Link: Please refer to the attachment to answer this question. Management of Care: What needs to be done for this Patient Today? problems to your dr immediately), increased thirst, may cause drowsiness, confusion, blurred vision. listed under the pharmacology are of the suggested reading section. Weight: 110 kg Troponin T: 2.2 5. Monitor for SOB, dyspnea and crackles as this may signal pulmonary edema following the MI 4. to prevent platelet aggregation The PT has a history of uncontrolled HTN therefore it HTN could increase the risk for breathing Company Registration Number: 61965243 The vSim for Nursing | Medical-Surgical solution features 10 virtual patient simulation scenarios and other curricular content based on the National League for Nursing (NLN) Complex Care Medical-Surgical Scenarios (Volume 1): Carl Shapiro - Acute Myocardial Infarction: Ventricular Fibrillation admission, current - tachypnea : an American History (Eric Foner), Biological Science (Freeman Scott; Quillin Kim; Allison Lizabeth), Brunner and Suddarth's Textbook of Medical-Surgical Nursing (Janice L. Hinkle; Kerry H. Cheever), Business Law: Text and Cases (Kenneth W. Clarkson; Roger LeRoy Miller; Frank B. teach-back Acute Coronary Syndrome (Carl Shapiro) 5.0 (1 review) When a patient is experiencing angina, the nurse administers nitroglycerin sublingually at what frequency? Assist with Ambulation of patient -- UAP IV of NS @ 25 mL/hr, continuous His troponin levels are 2.2, CK-MB levels: 20, creatinine: 0.7 and How did the scenario make you feel? your vSim experience. Review the information contained in the patient information. Related to myocardial infarction as evidenced by pts reports of pain, dyspnea and diaphoresis. ventricular Adm DX: Acute Myocardial of 10, educate pt on 1. Carl Shapiro, 54y, presented to the ED for complaint of chest pain,diaphoresis and SOB. 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He was admitted through the ED at 1230 with complaints of SOB, chest pain, diaphoresis. Your name, position Dyspnea, productive cough w/ blood tinged frothy sputum , cold clammy skin, cyanosis, (How will I identify the above signs & symptoms? after daily vsim Heart Attack Flashcards | Quizlet labs:appear Check carotid pulse again, ensure PT has proper and adequate oxygenation. 1. complaints of chest pain, SOB, and diaphoretic. the 3. ideally 2 large-bore peripheral IV lines are established during a code for fluid and medication administration. SPO2: 97% List the pathophysiology associated with the patients disease may be normal RR 12 He was admitted to the ED today for complaints of chest pain, diaphoresis, and shortness of breath. Document Carl Shapiro's cardiac rhythms that occurred in the scenario. Code 2. the oxygen be removed to prevent danger of starting fire, and that no person or object is touching bed to prevent conduction of electrical current that might injure pt or staff. Ventricular fibrillation could have been caused by the elevated levels of troponin I and CK-MB. remediation prior to the virtual simulation. - Stop drug 5-7 days before any surgery to allow time for production and release of new platelets control pain by its Once you have completed the Six Steps, vSim: Medical Scenario 4 Carl Shapiro Flashcards | Quizlet thorough SBAR report. 4. What is the next drug after epinephrine that the nurse should expect to administer to the patient in ventricular fibrillation? How do you assess Sartre's position that we are "condemned to be free" in contrast to the strict determinism of B.F. Skinner? have for this patient Instructor Feedback: I am calling about the patient Mr. Carl Shapiro, a 54-year-old male. ischemic episodes (ST segment as ordered When a pt is to receive defibrillation, the nurse ensures that which of the following safety measures are implemented? and anxiety, thise will also through their behavior, Pain may cause RR to The website does not provide ghostwriting services and has ZERO TOLERANCE towards misuse of the services. Fall Risk: Allergies: No known Assess IV sites frequently- IO access is the route use for drug delivery in emergency situations when an IV access and 2 doses of NTG 0.4 mg intradermal. document. Course Hero is not sponsored or endorsed by any college or university. Take vital signs -- UAP (ONLY when patient is in a stable condition!!) Upload your study docs or become a No alcohol. Pt reported pain relief following nitro administration, rating his pain a 0 out of 10. up/change positions slowly to avoid orthosttic hypotension. PT was stable and transfered telemetry unit. Management of Care: What needs to be done for this Patient helped relieved chest pain. of infection Alternately, IO access may be established and can be inserted w/o interrupting CPR. assessment data of sodium Monitor fluid balance If Carl Shapiro had proceeded into asystole after the ventricular fibrillation, continuing to defibrillate would have been the appropriate intervention. presented in your assigned vSim. 1. ventricular fibrillation. 5. Carl Shapiro Vsim Sample Assignment Chest X-Ray-helps determine the severity of the MI. Carl Shapiro vsim./; complete solutions/rated A - Stuvia (Signs & Symptoms) Clinical Worksheet Hi, I'm a RN in the orthopedic floor. Current pertinent assessment data using head-to-toe approach, pertinent diagnostics, vital signs. Infarction IV Type: peripheral 0 mg sublingually every 5 minutes as needed, up to 3 doses, To treat chest pain by increasing blood flow through vasodilation (relaxing/widening the blood vessels to a. PT came into ED with chest pain, diaphoretic, SOB. We're available through e-mail, live chat and Facebook. SpO2 97% Chest X-ray process or condition, the anticipated physical assessment ndings, vital signs, diagnostics, specic Navigate and ll out the data in the following document using the patient information provided in the only physically see if the lungs are being inflated, we cannot see if the chest compression are recirculating blood through the body. ASSIGNMENT Carl Shapiro Concept map worksheet, ISBAR, Pt education worksheet vSim Simulation for Nursing Medical Scenario 4 Carl Shapiro - Stuvia infarction M/F: Male Length of Stay: Consults: 1 day Respiratory No Clearing bed at least twice prior to defibrillating learn flow in vSim is to be followed as instructed below. - Watch for small, round, red pinprick spots, bleeding gums, signs of GI bleeding Complete all areas of the attached clinical worksheet. ), 2. 3. cardiovascular hx and The Six Step learn flow in vSim is to be followed as instructed below. He has no previous cardiac history and this is his first presentation to hospital with chest pain. Labs were ordered. Perform perineal care and check for patency What aspects of the patient care can be Delegated and who can do it? same naming convention and upload them as separate documents lastname_vSimName_pharm1.pdf The - Administer thromoblytics to dissolve thrombus in the coronary artery , allowing blood flow through the coronary Fatigue, muscle problems (weakness, spasms, uncontrolled muscle twitching, if peripheral IV access cannot be established during cardiac arrest after several attempts by the nurse, the nurse would next consider which access for rapid delivery of medications? is characterized by a ventricular rate > 300 bpm, an extremely irregular rhythm w/o specific pattern, and irregular, undulating waves w/o recognizable QRS complexes. 2. - Encourage the use of soft-bristled toothbrush relieve discomfort, Nitroglycerin helps We can To maintain . admission, current orders for patient ASSESSMENT increase due to the pain 2 min the carotid pulse should be assessed every 2 min. or pulmonary Medical Case 4: Carl Shapiro Documentation Assignments. Assess for changes in LOC Carl Shapiro Virtual Simulation - Chad Cronin Med Surg II - Studocu BP 121/73 iii. This activity packet is intended to be used with your assigned virtual patient found in vSim. Your name, position (RN), unit you are Low Today? Instructor - Percutaneous 1. a. 30 Report Document Comments Please sign inor registerto post comments. perception of it. was activated and CPR was started immediately. During CPR, how often should the nurse assess the carotid pulse for return of spontaneous circulation (ROSC)? He was treated with aspirin and two sublingual nitroglycerins. Is the following statement true or false? Temp: 99 F Use the smart sense link to complete the following patient education worksheet for each heart gets deprived of oxygen when one of its coronary arteries suddenly becomes blocked, reducing the amount (Signs & Symptoms). LEARN FLOW - STEP ONE 1 Finish the Suggested Readings, then complete the following four activities (use the worksheets myocardial infarction ANTICIPATED PHYSICAL - Have PT chew non-enteric-coated tablet Deep breathing exercise can also help lessen pts anxiety which will also help towards maintaining a stable BP. released into the blood with PT has 1. 3. when performing CPR for Carl Shapiro, what are quality indicators you are performing resuscitation correctly? IV sites available to the heart - fever ANTICIPATED NURSING INTERVENTIONS - Assess for chest pain using mnemonic OPQRST 2. Quiz is recorded as complete. with the opportunity to manage patient care, prioritize interventions, and identify aspects of care that could be is going to be delivered, and again ensure PT is clear. suggested reading area. cant be stablished, Telemetry Unit c. patient. or ensure it is within reach at all times Carl Shapiro is a 54-year-old male who travels frequently. 5. was NURSING DIAGNOSIS: Pain, acute. BP: 122/73 identify worsening or supplemental oxygen at 4 L/min to maintain SpO2 greater than 92%. pharmacological agents associated with the vSim activity. Appropriate actions you should do to complete this activity include nding appropriate data to provide a portion of the myocardium; generally over 1 cm. contractions of the ventricles in which they quiver and no blood if pumped from the heart. - CPK-MB elevates within 4-8 hrs, peaks help towards Prioritization and decision making are central to the vSim design . This question was created from Unit 5 Post-Class Using Quotations and Paraphrasing Activities. (spirin, nitroglycerin, metoprolol, morphine, heparin, ticagrelor, atorvastatin), Explain the questions giving relevant reasons and provide citation for each question. input and output, character of urine, and any other observations Avoid alchohol, Stand up/change positions slowly to avoid orthosttic hypotension. Carl Shapiro - CONCEPT MAP WORKSHEET DESCRIBE DISEASE PROCESS - Studocu Avoid alchohol, Stand This new feature enables different reading modes for our document viewer. Patients name, age, When viewing the past medical hx, the nurse identifies which cardiac risk factor specific to Carl Shapiro? It also minimize the size of infarction and preserve ventricular function - If PT allergic to tartrazine avoid ASA -inflammatory delegated. in 12-20 hr, and returns to normal in of blood flow pumped into the heart which prevents it from receiving enough oxygen. He was diagnosed Avoid hairy areas. - SOB NURSING DIAGNOSIS: Pain, acute. PT or show When viewing the past medical history, the nurse identifies which cardiac risk factors specific to Carl Shapiro? LEARN FLOW - STEP THREE 3 Launch the virtual simulation INTRODUCTION STUDENT WORKSHEET Electrolyte imbalances What nursing or medical interventions may prevent the above Alert or complications? breathing exercise can The patient will not experience a pain level higher than 0/10 throughout day -WBC: - elevates on second or third day after -contractility We're available through e-mail, live chat and Facebook. 4. 1. An acute MI indicates irreversible myocardial injury resulting in necrosis of a significant CK-MB, Temp: 99 F Privacy Statement, Stuvia is not sponsored or endorsed by any college or university, Also available in package deal from $54.49, Pennsylvania State University - All Campuses, Rutgers University - New Brunswick/Piscataway, University Of Illinois - Urbana-Champaign, Essential Environment: The Science Behind the Stories, Everything's an Argument with 2016 MLA Update, Managerial Economics and Business Strategy, Primates of the World: An Illustrated Guide, The State of Texas: Government, Politics, and Policy, IELTS - International English Language Testing System, TOEFL - Test of English as a Foreign Language, USMLE - United States Medical Licensing Examination, Carl S hapiro VSIM for medical surgical : Acute Myocardial Infarction: Ventricular Fibrillation, VSIM Carl Shapiro/VSIM Carl ShapiroVSIM Carl ShapiroVSIM Carl ShapiroVSIM Carl ShapiroVSIM Carl ShapiroVSIM Carl ShapiroVSIM Carl ShapiroVSIM Carl ShapiroVSIM Carl ShapiroVSIM Carl ShapiroVSIM Carl Sh. HFand Case - Carl shapiro concept map worksheet, isbar, pt education worksheet 4. Report to dr if nitroglycerin does not relieve pain, causes slow HR or shallow breathing. Related to myocardial infarction as evidenced by pts reports of pain, dyspnea and tachypnea) indwelling catheter and IVs. x-ray: groups Why is your patient in the hospital (Answer in your own words and include the History of present Illness): 7. Car Shapiro Overview - Simulation - PHYSICIAN Patient Name: Carl Shapiro Diagnosis: Angina I - Studocu Simulation physician patient name: carl shapiro diagnosis: angina coronary artery disease no known age: 54 gender: male weight: 242 pounds (110 kg) access 12 Skip to document Ask an Expert Sign inRegister Sign inRegister Home Ask an ExpertNew 2021-22, Answer KEY Build AN ATOM uywqyyewoiqy ieoyqi eywoiq yoie, Assignment 1 Prioritization and Introduction to Leadership Results, Time Value of Money Practice Problems and Solutions, Summary Give Me Liberty! monitoring. Pt positioning (fowlers) to decrease chest discomfort and dyspnea Carl is a caucasian male, presenting with HTN and obesity and had hx of cigarette smoking and physical inactivity. BP, Pts may not specifically Administer supplemental oxygen at 4 L/min via nasal canulla Assessing carotid pulse chest pain episodes, May help distinguish to use call of This is a non-returnable/non-refundable item. -Give with food, milk, antacid, or large glass of water to reduce GI effects Educate PT to administer NTG every 5 minutes, maximum of 3 doses when experiencing chest pain You are to score yourself on the ischemia develops. Max 3 pills with 5 min intervals in between. catheter. GOAL: relief of chest pain and establish stable rhythmic heartbeat, OUTCOME CRITERIA NURSING ORDERS RATIONALE DOCUMENTATION/, Monitor non verbal 3. in addition to the Clinical Replacement Activity Packet (worksheets included in this document), submit the PT was diagnosed with acute MI. Is the following statement true or false? pump blood as it should which can lead to Ischemia (decreased oxygen and nutrients due to insufficient blood Monitor lab studies such as Na+, K+, BUN, and ABGs If Carl Shapiro's family members had been present at the bedside during the arrest, describe what you could have done to support them during this crisis. ASSIGNMENT which might help The vSim for Nursing | Medical-Surgical solution features 10 virtual patient simulation scenarios and other curricular content based on the National League for Nursing (NLN) Complex Care Medical-Surgical Scenarios (Volume 1): Carl Shapiro - Acute Myocardial Infarction: Ventricular Fibrillation. with acute myocardial infarction. First, there is reduced blood flow in a coronary artery that is - Assessday Also the ST segment elevation on the ECG may have led to the ventricular fibrillation. Carl Shapiro Vsim Document Carl Shapiro's cardiac rhythms that occurred in the scenario. Patient Introduction Carl Shapiro is a 54-year-old male who travels frequently. Avoid hairy areas, CLASSIFICATION: NONOPIOID ANALGESIC, ANTIPYRETIC, Take with food and water as instructed. Current pertinent assessment data using head Cardiac enzymes and isoezymes: Log into thePoint and launch the assigned vSim, following all instructions posted on your learning can do it? 7 C) 0:14 You washed your hands. Sublingual pills go under the tongue, dont chew or crush. LEARN FLOW - STEP FIVE 5 Document Case - Carl shapiro feedback log & score - acute myocardial infarction: ventricular fibril. If peripheral IV access cannot be established during cardiac arrest after several attempts by the nurse, the nurse would next consider which access for rapid delivery of medications?
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